title: Prevalence and predictors of persistent health status impairment in patients referred to a vascular clinic with intermittent claudication.
abstract: BACKGROUND
  The goal of treatment for lower extremity peripheral artery disease is often to improve health status. Factors associated with failure to improve are unknown.
  
  
  METHODS
  Health status was assessed with the Peripheral Artery Questionnaire (PAQ) at baseline and 2 years in 344 patients referred to vascular clinics. Improvement was defined as an increase of ≥5 points on the PAQ Summary Score. Multivariable logistic regression identified patient and treatment characteristics associated with impaired baseline health status, and predictors of no improvement (<5 points).
  
  
  RESULTS
  Older age, bilateral symptoms, female sex and prior revascularization were associated with impaired baseline health status. At 2 years 36% reported unimproved health status. Factors associated with no improvement were older age (Odds Ratio 1.67/decade, CI 1.28, 2.19), better baseline health status (OR 1.40/10-points, CI 1.24, 1.59), beta blocker use (OR 2.53, CI 1.37, 4.68), prior stroke (OR 4.12, CI 1.33, 12.77) and bilateral claudication (OR 1.79, CI 1.07, 2.99).
  
  
  CONCLUSIONS
  Older patients, women, and those with bilateral symptoms or prior revascularization have worse health status at vascular referral. Over 1/3 of patients' health status did not improve over 2 years; older patients and those with bilateral or milder symptoms, prior stroke or using beta blockers were less likely to improve.
authors.affiliation: Saint Luke's Mid America Heart Institute, Kansas City, MO, United States. dsafley@cc-pc.com
authors.forename: D M
authors.initials: DM
authors.lastname: Safley
authors.forename: K F
authors.initials: KF
authors.lastname: Kennedy
authors.forename: G
authors.initials: G
authors.lastname: Stansby
authors.forename: M
authors.initials: M
authors.lastname: Flather
authors.forename: D J
authors.initials: DJ
authors.lastname: Cohen
authors.forename: J A
authors.initials: JA
authors.lastname: Spertus
mesh_terms: D000368:Aged; D005260:Female; D006304:Health Status; D006801:Humans; D007383:Intermittent Claudication / Q000453:epidemiology* / Q000209:etiology; D035002:Lower Extremity; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000150:complications / Q000628:therapy*; D015995:Prevalence; D012042:Registries; D011795:Surveys and Questionnaires